Would you look at that! South Dakota’s very own Mediterranean champion of the people, Rep. Tony Venhuizen is back on the warpath. This time he’s armed with a legislative parchment that would have the good folks of our state vote on a “clarification” to Medicaid expansion passed in 2022. Because, who doesn’t love a good “clarification” vote, am I right?
Not to be outdone in the legislative relay race, Sen. Casey Crabtree of Madison has joined forces with Venhuizen in this rambunctious resolution rodeo. The proposed ballot measure would pose a question to the voters in 2024 about whether the state should consider adding work requirements to the Medicaid enrollment process. A cautionary tale, this similar resolution was pinned during the 2023 session but was accused of having an overly broad span – a scenario that surely triggers déjà vu for Venhuizen.
Advocates (aka people who’d rather not see complications add to the plate of those relying on Medicaid) argue that work requirements haven’t exactly won medals for successful implementation in the past and could possibly be a wrecking ball to small businesses. But hey, who doesn’t love a challenge?
In the ever-evolving relay race of healthcare, South Dakota has managed to spread its legislative wings, joining the bandwagon of 41 states that have expanded Medicaid since 2012. This expansion, a.k.a. the Affordable Care Act, offers coverage to adults under 65 who do the unthinkable act of earning less than $20,000 or are part of a family of four making less than $41,000.
This constitutional amendment was favored by voters in 2022 with a 56%-44% margin, making health coverage a reality for an estimated 52,000 South Dakotans. A monumental moment indeed!
The said expansion took off in July, prompting the state to set aside a cool $589 million for the administrative and benefit costs and also to create 68 full-time spots within the Department of Social Services to manage the program.
Now, let’s get back to the crux of the matter – the 2024 resolution. Venhuizen, the legislative linguist, is fixated on narrowing down the language of the resolution, ensuring it only applies to the non-physically or mentally disabled enrollees of the Medicaid expansion program. That is, of course, if the federal government allows it. The current Biden administration is not too keen on work requirements for the Medicaid expansion population, but hey, we all know political winds can change rather quickly.
In 2019, Arkansas, land of the aspirations, rolled out its Medicaid work requirements only to have it put on pause after it led to a quarter of the enrolled population losing coverage. A federal appeals court came down with a ruling, deeming the work requirements as “‘arbitrary and capricious’ and failed to further the objective of the Medicaid program”. And, that’s according to Healthcare Dive, your go-to for healthcare industry publication.
So, here’s to the possibility of the upcoming 2024 “clarification” vote and may our legislative champions have another shot at running the resolution relay. After all, who doesn’t love a good “work requirement” rerun? Or perhaps, we could tackle other “clarifications” voters might have about things like, oh, education reform, energy policy, or dare I say, term limits? But that’s a topic for another day. Until then, happy politicking on the plains, South Dakota!